Third, the ectoenzyme, CD38, on MM-derived EVs converts nucleotides into adenosine, which is a well-known suppressor of the immune system [122].Finally, CD38-positive EVs were shown to be internalized by FcR-positive cells, such as monocytes, MDSCs, and NK cells, after binding to an anti-CD38 mAb (daratumumab), although the effects are still under investigation [123]. Here, CD38 is linked to Miyoshi myopathy.